Chronic eosinophilic pneumonia: treatment with inhaled corticosteroids.

Abstract

BACKGROUND:

Chronic eosinophilic pneumonia (CEP) is highly sensitive to systemic corticosteroids, but frequently relapses if the dose is tapered or treatment discontinued. Long-term usage of systemic corticosteroids may cause side effects. Alternative treatments are therefore desired.

OBJECTIVES:

We evaluated the response of CEP to monotherapy with inhaled corticosteroids (ICS).

METHODS:

Four patients who had CEP without spontaneous resolution were studied. Patients received inhaled beclomethasone dipropionate (BDP) at a dose of 0.8 mg/day in 1 patient and 1.6 mg/day in 3 patients for 2 weeks. Treatment was continued if a patient showed improvement in at least 1 of the following indices: radiological findings, symptoms, and blood eosinophilia.

RESULTS:

After the initial 2 weeks of treatment with BDP, the blood eosinophil count increased in 2 patients and decreased in 2. Symptoms worsened in 2 and improved in 2. Infiltrates on chest radiography increased in 3 and showed little change in 1. In the 2 patients with worsening of all 3 outcome indices, oral prednisolone was started; the indices improved. In the remaining 2 patients, BDP alone was continued. One patient had worsening of CEP after 2 months of treatment, and another had relapse of CEP at 3.5 years while receiving 1.6 mg/day of BDP. All patients thus finally had worsening or relapse of CEP during treatment with BDP.

CONCLUSIONS:

ICS may not be effective when given as monotherapy in patients with CEP.

• Authors: Masayoshi Minakuchi, Akio Niimi, Hisako Matsumoto, Ryoichi Amitani, Michiaki Mishima
• Journal: Respiration; international review of thoracic diseases (Respiration) 2003 Jul-Aug Vol. 70 Issue 4 Pg. 362-6 ISSN: 0025-7931 [Print] Switzerland
• PMID: 14512670 (Publication Type: Journal Article)
• Copyright: Copyright 2003 S. Karger AG, Basel

Chemical References

• Anti-Inflammatory Agents
• Glucocorticoids
• Prednisolone
• Beclomethasone

Topics

• Administration, Inhalation
• Administration, Oral
• Anti-Inflammatory Agents (administration & dosage, adverse effects)
• Asthma (complications)
• Beclomethasone (administration & dosage, adverse effects)
• Blood Cells (pathology)
• Chronic Disease
• Eosinophils (pathology)
• Female
• Follow-Up Studies
• Glucocorticoids (administration & dosage, adverse effects)
• Humans
• Leukocyte Count
• Middle Aged
• Prednisolone (administration & dosage)
• Pulmonary Eosinophilia (complications, drug therapy, pathology, physiopathology)
• Respiratory Function Tests
• Time Factors
• Treatment Failure